NPIMap

Organization Active NPI

Atkinson Fire Protection District

  • Land Ambulance
  • Atkinson, IL
National Provider Identifier
1619139409
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
02-2517 Issued in IL
Legal business name
ATKINSON FIRE PROTECTION DISTRICT
Practice address
101 E Henry St
Atkinson, IL 61235-7713
Phone
(309) 936-7220
NPI assigned
Jul 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Maryclair Gustafson
Title
Trustee
Phone
(309) 936-7220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 02-2517 IL Primary

Addresses

Primary practice location

101 E Henry St
Atkinson, IL 61235-7713

Mailing address

PO Box 140
PO Box 140
Atkinson, IL 61235-0140
Phone (309) 936-7979

Other identifiers 1

IdentifierTypeStateIssuer
942930OtherILMEDICARE PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120501000606 IL Part B Supplier - Ambulance Service Supplier 2961664362 Practice locations: Atkinson, IL

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1619139409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140",
            "address_2": "PO BOX 140",
            "city": "ATKINSON",
            "state": "IL",
            "postal_code": "612350140",
            "telephone_number": "309-936-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E HENRY ST",
            "city": "ATKINSON",
            "state": "IL",
            "postal_code": "612357713",
            "telephone_number": "309-936-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATKINSON FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "MARYCLAIR",
        "authorized_official_title_or_position": "TRUSTEE",
        "authorized_official_telephone_number": "309-936-7220"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "02-2517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "942930",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.